In 2007, Josh Nesbit worked at a Malawian hospital that served 250,000 patients spread over 100 miles. Remote patients were reached by volunteer community health workers, who often had to walk 35 miles to report back to clinicians. Josh realized the potential of mobile technology to reach isolated patients and save follow-up time and travel fuel. He founded Medic Mobile to connect people at every level of the health system—from policymakers to clinics to community health workers. Today, his programs have been implemented at hospitals in nine countries, including 50% of Malawian district hospitals.
We asked Josh a couple of questions about the moment he knew he was making a different with his project and his future goals.
DoSomething.org: How did you feel when you first learned of the problem you’re addressing?
Josh Nesbit: I first learned about a very specific problem at a single hospital in rural Malawi. Volunteer community health workers were trying to provide healthcare in their villages, but they had to walk forty miles to the nearest hospital. There was no emergency care, patient adherence rates suffered, and drug stock outs were common. I had an overwhelming and inspiring feeling that this problem could be tackled in partnership with the hospital and the health workers.
DS: How do you feel about it now?
JN: I have found that for every new project that’s launched, the need for two others is unveiled. While it is sometimes difficult to process this demand, I am working with an amazing team - our ambitions and self-efficacy have kicked in, and we have very ambitious plans for growth and impact. We know that gaps in healthcare systems in challenging settings around the world can be bridged with mobile tools. We are aiming to equip hundreds of thousands of health workers with our technology.
DS: What person or experience sticks with you from when you first started your project?
JN: A man with epilepsy had fallen into a fire roughly fifty miles from the hospital - Pascalia, a community health worker living two houses away, texted into our SMS hub saying the man had developed a bad ulcer on his heel. I jumped on the back of a motorcycle with the Home-Based Care nurse and a bag of supplies, and we made it out to Pascalia’s village to see the patient. The entire community gathered - this was the first time they’d seen this type of response. Normally, the patient would be pedaled or carted to the hospital in a grueling, full-day trip.
DS: Who or what is your inspiration to keep going?
JN: I believe that community leaders are saving the world, every day. On my first trip to Malawi, I met Dickson Mtanga, a volunteer community health worker. He always carried a notebook tightly wrapped with newspaper; one day, I asked him what it contained. He opened it to reveal hand-written drug adherence and symptom charts for 25 HIV-positive patients his was tracking in his village - Dickson was walking half a day to the hospital every week to deliver these updates. I can’t help but be inspired by health workers like Dickson. My teammates, friends, and family also play a huge role in fueling and refueling this work.
DS: Can you describe the moment you knew that you were actually making a difference?
JN: Six months after the pilot started, I returned to the hospital to evaluate the program - through text messaging, staff had saved thousands of hours in travel and work time, doubled the number of patients being treated for Tuberculosis, and implemented an emergency care system for the first time. Once we had these results, there was no turning back - my teammates and I were spending ten hours a day from our dorm rooms discussing expansion with Ministries of Health, NGOs, and individual clinics around the world.
DS: What was the most difficult roadblock you faced when you tried to start your project? When you were growing it?
JN: At the start, it was difficult to juggle the logistics of studies, college soccer, an honors thesis, and a new project - but it was well worth the sleepless nights. As the project has grown, it’s become clear that our work can be amplified with more resources. It’s tough to know that we’re not fully meeting demand for services and tools, just yet.
DS: What’s been the biggest lesson through the process?
JN: There’s a great quote I read in an article recently: “Entrepreneurs thrive on contingency. The best ones improvise their way to an outcome that in retrospect feels ordained.” Don’t stop, keep innovating, and we’ll get there.
DS: What has surprised you the most about the journey that has taken you here today?
JN: I have been surprised by the power of mindsets. If I approach a big opportunity with raging optimism, there’s a 1 in 10 shot it will work out. If I let that optimism slip, that ratio falls to 1 in 1,000.
DS: What advice do you have for other young leaders who are having a tough time getting their ideas off of the ground?
JN: Problems abound because it takes inertia, momentum, and persistent movement for change to occur. Keep pushing. I am continuously inspired by Millennials that I meet; the generation represents a relentless, positive storm.
DS: If you could have done one thing differently based on what you know now, what would it be and why?
JN: Tweaking the past is tricky! I’m not sure I’d do anything differently. Perhaps I’d begin making direct asks for support and funding earlier on in the project.
DS: What’s next for your project?
JN: We are very excited by the prospect of expanding to Latin America. In Colombia, we are planning landmine victim assistance and community-based rehabilitation initiatives working with a network of partners in rural areas. In Nicaragua, we want to help women and their health workers manage chronic illnesses. If Medic Mobile is awarded funding from Do Something, it will directly support this expansion.
Bonus Question: If you could have any celebrity film a PSA for you, who would it be and why?
JN: I have to choose Justin Bieber. We have a campaign in the US, Hope Phones, which asks Americans to donate their old cell phones. We recycle the phones here and use the proceeds to purchase new phones in local markets for health workers. Bieber fans would collect tons upon tons of cell phones!
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